Case Report Abstract Sagittal malalignment after intramedullary fixation of proximal third tibial shaft fractures has been described frequently, but almost every reported case involves a procurvatum deformity. We report 2 cases of recurvatum deformity of proximal third tibial shaft fractures where the Synthes EX tibial nail was used. The recurvatum deformity may have been induced by the shape of the nail, with its more distal Herzog curve relative to designs from other manufacturers.